Active NPI
JFJ Eyecare, LTD
- Optometrist
- Swansea, IL
National Provider Identifier
1376586685
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- Legal business name
- JFJ EYECARE, LTD
- Practice address
- 3990 N Illinois St
Swansea, IL 62226 - Phone
- (636) 200-4393
- Fax
- (618) 277-6651
- NPI assigned
- Jun 14, 2006
- Organization subpart
- No
Authorized official
NPPES NPI Registry- Name
- James Wachter
- Title
- Cmo
- Phone
- (636) 200-4393
Practitioners 40
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL, MO
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040805000548 | IL | Part B Supplier - Clinic/Group Practice | 8224009865 |
Receives reassigned benefits from 31 practitioners Practice locations: Highland, IL; Effingham, IL; Maryville, IL; Mattoon, IL; Mount Vernon, IL; Pinckneyville, IL; Red Bud, IL; Salem, IL… |
| O20111026000149 | MO | Part B Supplier - Clinic/Group Practice | 8224009865 |
Receives reassigned benefits from 5 practitioners Practice locations: Saint Louis, MO; Hannibal, MO; Creve Coeur, MO; Chesterfield, MO |
National Provider Directory
National Provider Directory- Tax ID family
- Terence G Klingele MD L
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Optometrist
- Fairview Heights, IL
- NPI 1386069045
Locations
111 W Lincoln St
Belleville, IL 62220
Phone (618) 234-1774
425 W Holmes St
Chester, IL 62233
Phone (618) 826-4521
1200 N State St
Freeburg, IL 62243
Phone (618) 539-5620
2421 Corporate Ctr
Ste 102
Granite City, IL 62040
Phone (618) 451-7925
530 E Broadway St
Sparta, IL 62286
Phone (618) 443-4721
Specialties & licenses 1
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | Primary |
Addresses
NPPES NPI RegistryPrimary practice location
3990 N Illinois St
Swansea, IL 62226
Mailing address
PO Box 415000
Nashville, TN 37241-2019
Phone (636) 200-4393
Other practice location 1
4900 W Main St
Belleville, IL 62226-4725
Phone (618) 235-2400
Other practice location 2
1310 Dadrian Professional Park
Godfrey, IL 62035-1685
Phone (618) 433-5005
Other practice location 3
12 Professional Park Dr
Maryville, IL 62062-5672
Phone (618) 288-7266
Other practice location 4
2121 S State Route 157
Edwardsville, IL 62025-3607
Phone (618) 277-1130
Other practice location 5
400 N Broadway Ave
Salem, IL 62881-1514
Phone (618) 277-1130
Other names 1
NPPES NPI Registry- Quantum Vision Centers
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 12, 2024.
{
"created_epoch": "1150243200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1731369600000",
"number": "1376586685",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 415000",
"city": "NASHVILLE",
"state": "TN",
"postal_code": "372412019",
"telephone_number": "636-200-4393"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3990 N ILLINOIS ST",
"city": "SWANSEA",
"state": "IL",
"postal_code": "62226",
"telephone_number": "636-200-4393",
"fax_number": "618-277-6651"
}
],
"practiceLocations": [
{
"address_1": "4900 W Main St",
"address_purpose": "LOCATION",
"city": "Belleville",
"state": "IL",
"postal_code": "622264725",
"country_code": "US",
"telephone_number": "618-235-2400",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1310 Dadrian Professional Park",
"address_purpose": "LOCATION",
"city": "Godfrey",
"state": "IL",
"postal_code": "620351685",
"country_code": "US",
"telephone_number": "618-433-5005",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "12 Professional Park Dr",
"address_purpose": "LOCATION",
"city": "Maryville",
"state": "IL",
"postal_code": "620625672",
"country_code": "US",
"telephone_number": "618-288-7266",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2121 S State Route 157",
"address_purpose": "LOCATION",
"city": "Edwardsville",
"state": "IL",
"postal_code": "620253607",
"country_code": "US",
"telephone_number": "618-277-1130",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "400 N Broadway Ave",
"address_purpose": "LOCATION",
"city": "Salem",
"state": "IL",
"postal_code": "628811514",
"country_code": "US",
"telephone_number": "618-277-1130",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "JFJ EYECARE, LTD",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-14",
"last_updated": "2024-11-12",
"certification_date": "2024-11-12",
"status": "A",
"authorized_official_last_name": "WACHTER",
"authorized_official_first_name": "JAMES",
"authorized_official_title_or_position": "CMO",
"authorized_official_telephone_number": "636-200-4393"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Optometrist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Quantum Vision Centers",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Swansea, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.